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<br />rfJ: -;J( Fe!. I/O 7~ ;2D--7t.f --,3 oT /fo-LLJ <br />r / _"> u c[/, > ~~ ~-r: 7> -,. C / vE . <br />APPLICATION FOR PERKlr" Fo/C- !'i IC- 0- ((If- Kf-e.~ <br />CITY OF ZEPHYRBILLS a i);v~ I:{lf~?-' F c~ ...:::rz; /5 , <br />BUILDING DEPARTMENT ;.1- I ,'t') s' j:/111 /7-. ~/fo7(.:' <br />, jUt-' ~ &"17l-&~~tI. " f'. / c< <br /> <br />(7 pb h' II. tn+AI- J L cd - 3 ,~~-z;;- .0, <br />OWNER'SNAHE-5t7 Y' IS' -e i) 'er. PHONE?I - '7-:2/ <br />OWNER'S ADDRESS Lj,?;3() -:Jo'f-+- Sf, I ?f'jJh'Y'r'h; lIs) Fe <br />JOB ADDRESS LJ ,~?D -- ~'fJ-- ,Sf, 2 r' (Jh y I~; II S / ,F C <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction _Addition ~teration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F <br /> <br />_, of Units _M/H <br /> <br />~ec:-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Deparbaent Approval <br />DESCRIPTION OF WORK:aQc\ .QO M~. I (\ h\~ (ry)l"-\ ~O:)m <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ ~ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />V KECllABICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />~J '):s QP- <br /> <br />I <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'l'ION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIOBS: <br /> <br />FT. <br /> <br />IS PROJECT IB FLOOD ZOBE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />BUILDER <br /> <br />F.T .F:CTRIClAN <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />Sismature <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />lImLWCAI, J COIIPANY \ A)' S-II'*Yl "1-, \ e . ,;, ~ r i (\ 1::1:e "-5 <br />A ' . State Cert. or Regist. t ~6'lq,,\ ~CCO\q I <br />Signaturell A.po 0 . '~~ City License Registration' "'P - I') 'lC\ <br />****************************************** <br /> <br />OTHF.R COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKlT OFFICER. <br />